How to help a depressed friend (and when to stop trying): part 2

Depressed people can be acutely hopeless and hard to console, making friendships difficult. Below are some of my thoughts about what friends can do for a depressed person and how friends can maintain appropriate friendship boundaries with the depressed person in their lives.

Validate the pain and move on. We know that distraction is actually good for depressed people, and rumination - going over the same negative feelings over and over - only encourages further depression. This is not to say that you should ignore your depressed friend's proclamations of sadness and misery. On the contrary: validation, listening, and acceptance are helpful, as is encouraging them to also do something other than wallow in their own misery.

Set boundaries. Depressed people may be acutely sensitive to rejection, and you may feel guilty if you try to set boundaries. Don't feel guilty. Think about what your boundaries are, and respect them. For example, are you o.k. with listening to the depressed person talk about their miserable life for 10 minutes, but not 1 hour? That's totally reasonable. Telling the person that you can only talk about their misery for a certain amount of time (10 minutes, 30 minutes, an hour, whatever you feel is reasonable), and that you will then need to change the subject, is appropriate. This should be something that they respect.

Expect reciprocity. Does the person reciprocate your help and care? Note that this may be difficult when the person is in an acute depression. People in the thick of a depression can be a bit self-centered, preoccupied with their own suffering. However, this is not an excuse for not honoring the friendship by at least trying to come through for another person. Even if the friend is too depressed to reciprocate now, a history of reciprocity and the expectation of future reciprocity is important. It is important to hold friends to the standard of reciprocity, or the relationship is no longer a friendship between peers, but something more like a therapeutic relationship or a caregiving relationship.

Ask them what they need, and tell them how you are willing to help. What does the person want? What does he or she want from you? How has the person responded to your previous attempts to help? Has the person responded graciously? Do not do more than you are willing to do. It won't do you any good to end up resenting the person and it won't do them any good to feel like you are only being their friend because you feel sorry for them.

Don't try to be the person's therapist. If the depressed person needs someone to call in distress in the wee hours of the morning during the time when you need to get your sleep, talks about committing suicide, or has been stuck in the same bad place for months or years on end, they should consult a therapist for professional help.

Concluding thoughts. Depression is among the hardest of hard times, and friends provide an invaluable source of social support and distraction for a depressed person. However, if your depressed friend consistently violates your boundaries or makes you feel guilty about them, and consistently fails to reciprocate or at least appreciate your care and support, then it may not be a healthy friendship for either party.

I feel that though I've tried these methods, it does not seem to work with the mister, who has been depressed for several years. He gets into bouts of self-pitying shame. If I silently listen to him, then give him advice on how to move away from the shame, he gets mad at me for somehow validating his shame and his feelings...as if somehow my nondenial of X means I really believe he is X. If I deny that he is X straight away, then I am "dismissing" his feelings.

Also, I've asked him what he needs, but as a depressed man, he doesn't know what he needs. He feels that since I've dated him for so long, I should automatically know what he needs. Or something. I don't know. All I know is that he gets mad if I ask him what he needs from me. Oi.

I've been friends with the person for more than 7 years now. Through the years, all he ever to talked about was his failed marriage to someone he was with for a good 11 years. There was something wrong with the family dynamics of the girl and she was not mature enough to know what a marriage entails. In any case, my friend and I have been in and out, kept in touch sometimes and then we'd have a fight, not talk. Around March of last year we got together again. This time we became closer. His business started to dwindle. He started to owe me money. We'd go out drinking and other things on my dime (he kept saying he'd pay when he gets collection from clients, which never materialized). Before you know it, he's living in my home, I'm providing for his needs to a point that I got really sick because I had to keep up with him making me lose sleep. From June, to date, I feel stuck. I am deep in debt. He's somehow got through the really bottom part of the depression. He's been trying to get back on track with business and putting himself together. But I just wondered, up to what extent should I continue to help? His family (mom and siblings) do not want to help him. His ex-wife, who got everything when she left, doesn't care about him either. They don't want to understand the disease. If I leave him alone, there is no one else. I care about the man a lot. I am making adjustments to my own personality just so we can get along with his depressed self. He understands the disease very well. He makes every possible effort to get better. Medicate, exercise. With no money to go see a doctor, I can tell he is trying to cure himself.

His existence in my life has truly consumed me. I was not aware until this year that it was depression. I didn't know it earlier on. I feel I suffered through it as a result.

I know you wrote this a while ago and will probably never read this. But I am going through a similar situation and I think he has hit rock bottom and I feel like I am the only reason he hasn't gone of and done something. But he has talked about wishing for a fatal disease and (he lives in a house) jumping off his roof. He , in all the years i have known him, is a trouble person and his mother suffers from depression but she is taking medication for it and his father thinks its an attitude adjusment problem and his mom wont help him becuase she would rather not argue with his dad. The man has his head stuck so far up his ass every decision he makes his killling his son. He has kicked him out, accused him of things and has the whole family thinking he is a bad seed and he isn't. He has no outlet, no one other talk to than me and i can't help him. If you have found a way to convince his family or any way that has helped him at all please let me know. my email is densonl88@hotmail. com. His parents wont even add him on their health insurance. I do not think they care for his wellbeing and if anything happens to him it will tear me apart.

The information here has been very helpful to me. So often, advice on how to help a depressed person is written by depressed people themselves, and they, of course, are focusing on their own needs, which are very high. I've spent the summer helping a depressed friend and now realize that by not establishing expectations of at least some reciprocity, I set myself up for being used. In the last few weeks, I've seen how little she cares about anything but her own problems and how reluctant she is to take any responsibility for them. Don't have huge regrets and have learned a valuablwe lesson. My sympathies go out to the other two posters here.

I am at my wit's end. *I* need help now! My best friend has been chronically depressed for a decade. She is so sweet (when she actually speaks), and I don't know if this is the reason she perpetually falls through the cracks. She goes to groups, she doesn't talk, nobody notices. She does one-on-one therapy -- they suggest she has post-traumatic stress disorder and should talk about childhood trauma, yet the sessions remain shallow and nothing ever happens. She pushes as hard as she can under the circumstances -- for good health. She exercises, she keeps trying to improve her medication, she tries to get the attention of therapists/psychiatrists.
I am empty and I feel callous about it all now. I love her and would do anything for her, but I do need support sometimes and she is never, ever able to give it to me. She calls me and then doesn't say anything. If I ask her questions, she replies, "It's good. Fine." And she is an expert hair-splitter; she does this to avoid asking questions and I hate it.
I'm angry. I feel like a jerk, too, for being angry when it's not her fault. I want to have something wonderful happen to me and know she will celebrate, instead of stop speaking to me because she feels awkward. She can't concentrate; she can't focus; she can be quiet for minutes at a time on the phone. It makes me CRAZY. I don't know what else to offer.
I am losing my best friend to the Deep Oblivion. It is awful.
Oh! And she "fakes" with strangers, co-workers. She only has friends who sit silently with her, or talk about the weather; thus, when she talks to me she is more likely to cry because she holds it all back, holds it all in.
I hate it. I'm angry. I'm a jerk for being angry.

When my friend does the same thing - holds it in in front of strangers, cries and exposes her misery around me - I also get angry, but I try to take a deep breath and be thankful that she feels such a closeness and security with me to be that vulnerable. Trust me, it doesn't always work and sometimes the anger wins out! But anger in the face of your own helplessness is a natural emotion. Since you say you're a jerk for being angry, I can tell you really care about your friend, because that guilt comes from split emotions; feeling empathy and frustration symultaneously. I hope expressing that here helps, because people in your same situation will understand, but don't blame yourself or beat yourself up over being angry.

I am in the same boat as Joon. My friend has been depressed for a decade. They visited for a few days and I just feel like all the happy has been sucked out of me. I know they are trying - therapist, different drugs, etc. but I just want to shake them and scream at them to do something already. I'm out of helpful suggestions or upbeat things to say and I know they are pointless anyway. I don't want to give up on them but I also am starting to want to not spend any time with them. Also noticed the total selfishness - never saying please or thank you, staring blankly at the wall until the conversation turns to something they like and then joining in (animatedly), etc. I often wonder if their family was less supportive if they would be forced to try harder, get a job, socialize more, get off the couch... Or if they'd be dead or homeless. It's pathetic and I feel like such a creep for wanting to distance myself.

Unfortunately for some depressed people their very condition encourages isolation because they can't or have difficulty reciprocating. But if you can't empathize, then you can't. Upbeat mantra doesn't work for someone who can't believe in the sincerity of them. While I recognize you are frustrated, please take this into account: He/she is depressed already and are not getting therapy for their condition to satisfy others--they need to work toward helping themselves with their depression.

Given their circumstance, I find it strange there's a tone of offense taken that he/she suddenly has interest in talking about something they like. If I were this person's friend, I would continue talking about things they liked. One of the worst things about depression is that an individual loses their interest in things--talking about things they enjoy and encouraging a glimmer of happiness even if temporary... I fail to see how this is so bad. And... heh, if anyone is staring blankly at a wall when you're talking maybe it's not entirely their condition--you could be an absolute bore!

What if he/she doesn't say please and thank you--would he/she also be scolded for not coming up to your measure of civility if they had a clearly visible physical disability or ailment? What if they very well ended up homeless or worse? From what I read, it doesn't seem to matter to you. Not your problem, right? While somewhat callous it's true enough. If you find the situation impossible then yes, distance yourself. I think it would be helpful to them in addition to yourself. But call yourself a friend, I don't very well think so.

And "forced to try harder?" That's just ignorant, counter-productive, and offensive.

I don't know if scolding Em for voicing frustration - even if admittedly it comes across slightly abrasive or unsympathetic - isn't just as counterproductive as scolding a clinically depressed person, Anon. I can understand your frustration, but this, to me, is an open forum to express such thoughts without harsh judgment.

Em, I say this without derision, but based on your response it sounds like you've never been depressed yourself, at least not at such a deep, abysmal level as what your friend is experiencing. Having never gone through it can make it doubly frustrating because you have no means to fully make sense of it as an illness. That frustration can lead to limited ability to empathize and build empathetic patience when dealing with your friend. There's no shame in that as long as you recognize how your expectations might come across as selfishness. Sometimes we can't see in ourselves the very same frustrations we find in others; it's a human proclivity.

That said, I'm dealing with a similar friend from the perspective of having been severely depressed myself, and it's *still* draining, painful and contagious. I may have developed extended patience because I know where she's coming from (even though I rarely say so because with her being depressed, I know she a) won't believe me and b) believes no one knows pain like she does. Self-imposed isolation and exception is a big component of depression.) but she is just as stubborn as she is depressed, and has convinced herself her life is destined for misery. I suffer trying to cope with that on my end, because I remember having those same dark feelings of finality and eternal pain, and I've come through it. I *know* it can change with the right treatment. Having found my own light at the end of a long, anguished tunnel, it breaks my heart to see her refuse help or support, whether mine or more importantly, that of a professional. I know and try, at least, to respect the limits of what I can do and what she'll best respond to, but it's a little slice of hell itself to feel so stuck, watching someone self-destruct, someone who is unable to cope and cannot reason a way to heal, someone who is so resigned to a life of emptiness that nothing anyone says or does will break through that wall. I don't try to be her savior, and I don't want to be her savior, I just pray from the depth of my soul that she gets the help she needs by whatever means possible, and I want to be there for her on the road while keeping my own sanity.

This article seems heartless and is less about helping the person with depression and more about how to avoid them, give them the 'suck it up" approach and treat them with the stigma of "chronically hopeless" person.

This article seems heartless and is less about helping the person with depression and more about how to avoid them, give them the 'suck it up" approach and treat them with the stigma of "chronically hopeless" person.

Those 19 steps will do more to help a friend than this article ever would.

i could not agree with anon more, what i heartless article. My friend feels alone, suicidal and has started cutting herself, i can't leave her, i can't say to her "i can give you ten minutes of my time, but not an hour because i don't want to" i fear that adapting the advice in this article would really make her feel totally isolated, alone and unimportant.

I read this extra article (anonymous' post) and found it one-sided. . . I adore my best friend with depression but we are at year thirteen now. Today I am the one struggling and I don't hear from her because she is freaked out by my struggles. I know she loves me. I know she is ill. But as the non-depressed person, I still exist and need my own support. I have a whole life that goes on when she vanishes, and while she intellectually understands this she does not fathom it.
What friends of depressed people need to know is how to be valued, how to put forth expectations. I deserve friends to worry about me when I stuggle.
Nobody can replace my depressed best friend who has been my great joy; but I need love and support too.
Amy

Those of you who find this article heartless are missing the point: Are you friends, or are you the mentor?
My best friend, chronically depressed, hasn't spoken to me in months. I had a few family tragedies and it overwhelmed her to see me sad. Now she feels so guilty about not being there for me that she can't bear to speak to me, so voila ~ I don't actually have best friend right now. I know she loves me. But I can't do anything with her good intentions.
Recently I had become her mentor. She was not a friend to me. She took hungrily but gave nothing. And in good times I haven't minded. But now I am the one who is hurting, and I am having to endure this without my soulfriend-confidante.
You guys need to understand that I am a person too. I have needs, and if she deserves to have support because she is depressed, why does that mean that I kowtow to her in this time of tragedy? I also exist. I also am worthy of love and support.
Someone needs to advocate for the needs of the mentor-friends, and that is what this article does. I have been the giver for 13 years, and now that I am grieving I do it without my best friend. People, that SUCKS. I completely understand why she is absent. She loves me. But at least give it to me ~ and all mentor-friends ~ that it SUCKS. We are lovable too! We are people too! We also need friends and supporters.
It is not *all* about the depressed person. It aggravates me how some of y'all think this.

I have been on both sides of this problem. I have a close friend who has been severely depressed for 6 years. The people who get angry with them the most are usually enablers (or co-dependent). Boundaries are needed, especially if the friend also suffers from depression. Ruminating and rehashing is very debilitating to both parties. I have sapped other friends' energy and patience by the depression caused by my friend. If you don't take care of yourself first, you are good to no one!

I am recovering from being codependent. My friend has been very depressed for 7³ years. I have bipolar disorder. I made the colossal mistake of thinking I could help. I had no boundaries for over five of those years. I have become depressed myself, and finally put up boundaries. I feel guilty, even though I know the anger and frustration I feel is from my own dysfunctional actions. I need to take care of myself now, and limit depressing talk for my own sanity. Of course, the depressed person did not try one thing I recommended, which were the same things recommended by the therapist. It is like being sucked into a vortex of black. I still listen, but wish my friend should get a boyfriend, so I would not be the first person to whom she turns.

While I understand this POV of the article, I do think it's heartless. I'm towards the end of my studies (a week to go) and been very stressed. I take care of myself so I don't get depressed.

I have leaned on a particular friend, sending a text message every 2/3 days.

Recently, she said it was too much for her and only contact her if its gets really bad.

I had thought text messages were non-intrusive and just an outlet to vent.
However, she felt it was stressing her out.

I reciprocate, I was there for her when she was down after breakups, work issues, and general self-doubt.

I find it difficult that she cut me off completely. As a friend, she knows she can count on me and this is really disheartening. I also think she's intentionally disruptive, a week before and now she decides she doesn't want to help.

Articles like this would benefit from explicit advice on how to talk to friends. Cutting them off and accusing them of disregarding you does not help.